Your best Annual Meeting Experience awaits.

Your bestAnnual Meeting Experience awaits.

VOLUME 1, NUMBER 2 • FALL 2015

TABLE OF CONTENTS:Smooth landing ahead 2Where in the world is the JCAAI? 3Your best Annual Meeting 4Great tech tools 7Experts await FITs 8Friends and new experiences 8

Can your practice perform better? 9Your professional development 10In memoriam 10Publications get makeover 11The facts on penicillin allergy 12Protecting kids, saving lives 12

And the winner is… 13Call for proposals 13Honoring our award winners 14Meet your candidates 15

Education, entertainment and excellence in San Antonio

2 CollegeAdvantage

Board of RegentsPresident: James L. Sublett, MD, FACAAIPresident-Elect: Bryan L. Martin, DO, FACAAIVice President: Stephen A. Tilles, MD, FACAAITreasurer: Bradley E. Chipps, MD, FACAAIImmediate Past President: Michael B. Foggs, MD, FACAAIPast Immediate Past President: Richard W. Weber, MD, FACAAIRegents: Gregory W. Bensch, MD, FACAAI; Curtis L. Hedberg, MD, FACAAI; Rohit K. Katial, MD, FACAAI; Tao T. Le, MD, MHS, FACAAI; Santiago E. Martinez, MD, FACAAI; Maeve E. O’Connor, MD, FACAAI; William S. Silvers, MD, FACAAI; Christopher C. Randolph, MD, FACAAI, and Cherie Y. Zachary, MD, FACAAI.

Speaker, House of Delegates: Kathleen R. May, MD, FACAAIFellow-in-Training Representatives: Andrew Nickels, MD, and Sarah Spriet, DOExecutive Medical Director: Bobby Q. Lanier, MD, FACAAIEditor-in-Chief, Annals of Allergy, Asthma & Immunology:Gailen D. Marshall, MD, PhD, FACAAIAlliance President: Judy FinemanExecutive Director: Richard J. Slawny

College Advantage is published by the American College of Allergy,Asthma and Immunology (ACAAI)85 W. Algonquin Road, Suite 550 Arlington Heights, IL, 60005Phone: 847.427.1200; Fax [email protected]

Smooth landing ahead A few months ago I compared the transformational changes your College has been implementing to “changing the engines in flight.” I am happy to report we have made the first leg of our flight and are coming in for a smooth landing with a tremendous educational program planned for this year’s meeting. The Annual Program Committee, led by incoming President, Bryan Martin, DO, FACAAI, has all the parts in place: topics, speakers, moderators, CME and MOC credits. All so that we can provide for your educational needs.

In mid-September, the Education Council, chaired by Dana Wallace, MD, FACAAI, held the inaugural Education Summit. It brought together stakeholders in all areas of allergy/immunology education, the College leadership and staff to map out a three-year plan for future educational offerings. Included in these efforts are programing and resources for both professional development and MOC. Read more on page 10.

We have also made great progress on Vision 2020 goals and priorities. An important aspect of Vision 2020 was the development of a new governance structure that helps the College be more efficient and gives members at different career stages an opportunity to serve. The new Appointments Committee, its chair, Kathleen May, MD, FACAAI, and the College staff, spent countless hours reviewing applicants and current committee membership to assure we reached our goal of establishing committees reflecting the diversity of the College.

J. Allen Meadows, MD, FACAAI, led the transition of the Joint Council to becoming the College’s 501(c)(6) subsidiary, rebranded as the Advocacy Council of ACAAI, still delivering the same services as JCAAI. Read more on page 3.

The House of Delegates (HOD) has been reorganized into six U.S. regions to better establish communication channels with local and state allergy/immunology societies. The HOD has already worked closely with the Advocacy Council to successfully address issues affecting allergists, such as state compounding laws.

The public facing portion of our website was launched shortly after the 2014 Annual Scientific Meeting. The new member website is scheduled to be revealed at this year’s meeting with new functionality, especially around education. If you haven’t already, visit the College Learning Connection at education.acaai.org to explore the opportunities.

My sincere thanks to the numerous College members and staff involved in these endeavors.

Connect with us at acaai.org or through:

COMMUNITY ADVANTAGE

President, American College of Allergy, Asthma, and Immunology

Fall 2015 3

ADVOCACY ADVANTAGE

Where in the world is the JCAAI?Have you been looking for the JCAAI lately? It’s right here!With a new name and a new look, the services you’ve come to expect and depend on are still here for you. After more than 35 years of serving as allergy’s independent advocacy organization, the JCAAI was restructured and became affiliated with the

College as the Advocacy Council of ACAAI. We’re excited about this new chapter and to be able to offer advocacy services to all College members as a

new member benefit.

The Advocacy Council consists of the same experts you’ve come to trust: J. Allen Meadows, MD, FACAAI, chair;

Stephen Imbeau, MD, FACAAI, vice chair; Donald Aaronson, MD, JD, MPH, FACAAI, director of

governmental affairs; and Gary Gross, MD, MBA, FACAAI, assistant director of governmental affairs. We’re all working harder than ever to protect College members – and the specialty.

Each Monday, the College Insider arrives

in your inbox and includes

the Advocacy Insider. Just like

JCAAI’s New News You Can Use,

the Advocacy Insider keeps you current on

ICD-10, Meaningful Use, EHR – and more.

Helping you navigate change. With all the shifts in health care, allergists need to make changes to adapt. The Advocacy Council is here to help you find your way. We’ll give you the map – you just need to follow it. The first stop on our map? ICD-10. The College Learning Connection at education.acaai.org is home to many resources to help you master these new codes, including:

• The Essentials of ICD-10: This webinar outlines the basics of ICD-10 and the differences from ICD-9.

• Top 50 Allergy Codes from 9 to 10: Convert the 50 most common allergy codes with this PDF.

• Member discount on coding books

• The Physician’s Perspective of ICD-10-CM: What do practicing allergists need to know about ICD-10 to make sure they get paid? This webinar dives deep into the

codes that you will use. Plus earn 1.5 CME.

• Our coding experts: Reach out to us at [email protected] with your tough coding challenges. We’re here to help.

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ANNUAL SCIENTIFIC MEETING ADVANTAGE

Your best Annual Meeting experience awaits: Education, entertainment and excellenceThe Annual Scientific Meeting is packed with symposia, lectures from expert speakers, new (and returning favorite) workshops, Meet the Professor breakfasts, fun networking events and attendee favorites like the Great Raft Debate and FIT Bowl. What do you absolutely need to add to your daily schedule to make this the best Annual Scientific Meeting yet?

Plenty of plenariesYou can’t miss the plenary sessions offered this year. On Saturday, get updates on new advances in the immune mechanisms of asthma and the role of personalized medicine at Biologics in Practice: Unique Opportunity for Allergist Expertise. “As we are on the cusp of having biologics available for severe asthma, we have the opportunity to review the pathways the emerging drugs target as well as the benefits and side effects. The allergist and immunologist can play a central role in the understanding and administration of new biologics,” said Rohit Katial, MD, FACAAI, moderator.

Right after that, all attendees should head to The Sky Is Not Falling: Flourishing Despite Tectonic Shifts to U.S. Health Care. Find out how to build a resilient office, hear about the trajectory of health care and the impact this will have on you.

On Sunday, learn to diagnose and manage patients allergic to implanted metal and other medical devices at Controversial Manifestations of Contact Dermatitis. Find out how gut microbiota dysbiosis contributes to aberrant immune development and how modification treats and prevents allergic disease and asthma at Human Microbiome: The Interface of Immunology and Microbiology.

We’ve saved some of the best for last. On Monday, attend Food Allergy: Component Test, CoFAR Studies, Practical Considerations to hear about the LEAP and CoFAR study results. Review treatment options and ways to monitor the burden of food allergy. Check out Updates in Severe Asthma to utilize biomarkers to categorize the endotype of a severe asthma patient, and design a tailored management plan. Stay for the Update on Anaphylaxis to review diagnostic criteria for mastocytosis and mast cell activation disorders and how to work with emergency physicians to increase referrals for allergy evaluations.

Connect with colleagues. Attend engaging sessions.Get the latest updates on topics important to the practicing allergist.

Fall 2015 5

Stay afloat at the Great Raft DebateA meeting highlight year after year, join us on Saturday for some laughs while you learn. “Medical meetings these days can be stuffy, death-by-Powerpoint sessions, with lecture after lecture being dished out to a passive audience,” said Maeve O’Connor, MD, FACAAI, moderator. “Not at the College’s Great Raft Debate – there is real electricity in the entire room.”

Moderated by Dr. O’Connor and William Dolen, MD, FACAAI, The Hottest Topic in EoE debaters are Amal Assa’ad, MD, FACAAI; Elizabeth Erwin, MD; Gailen Marshall, MD, PhD, FACAAI; and Jonathan Spergel, MD, PhD, FACAAI.

“This year’s debate is particularly interesting due to controversial data on the correct diagnosis, treatment plan, and long-term follow up of this emerging disease,” said Dr. O’Connor.

Hear from the expertsDon’t miss a great opportunity to learn from experts as they discuss topics important to practicing allergists. Named lectures include:

• Luisa Businco Lecture on “The Latest on Food Allergy Immunotherapy,” presented by A. Wesley Burks, MD, FACAAI, during the International Food Allergy Symposium. Hear cutting-edge research and outcomes. Nov. 5.

• Bernard Berman Memorial Lecture on “Adverse Reactions to Biologic Agents,” presented by David Khan, MD, FACAAI. Hear all about the side effect profiles of these new therapies and how to go about handling such complications. Nov. 7.

• Lester Mittelstaedt Lecture on “Why Creation of Successful “Systems of Care” is Crucial for our Future,” presented by Mark O’Hollaren, MD, FACAAI. “Change in health care delivery is accelerating, and it’s having a significant effect on both health care delivery systems and the providers expected to deliver that care, as physicians are experiencing significant stress and burnout,” said Dr. O’Hollaren. “I’ll outline the most likely trajectory of the U.S. health care system, and review the importance of developing systems of care. I’ll also provide recommendations to hopefully help our colleagues prosper in this new environment.” Nov. 7.

• Bela Schick Lecture “‘Oh, The Places You’ll Go!’ Dr. Seuss Reminds Us About Paths to Take,” presented by Todd Mahr, MD, FACAAI. Explore how life in the allergy field is a great balancing act, and to not be afraid to try new things…”there is fun to be done!” Nov. 8.

• John P. McGovern Lecture on “Developing Personalized Treatment for Severe Asthma,” presented by Bradley Chipps, MD, FACAAI. What role do biologics play in managing severe asthma? Find out how to develop a management plan that is individualized for severe asthma patients. Nov. 9.

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Find your directionAre you prepared to navigate the rapidly changing health care landscape? If not, attend the Town Hall Meeting, hosted by the ACAAI House of Delegates on Nov. 6. Enjoy a drink and snacks while expert speakers lead engaging discussions on compliance, quality measures, life after the SGR repeal and more.

“We’ll cover important issues like the ICD-10 transition, with tips for better coding so you get paid. Plus, we’ll update you on the progress of federally mandated alternative payment models and how this may affect allergy, as well as the potential revaluing of payments for allergy extract,” said J. Allen Meadows, MD, FACAAI, chair of the Advocacy Council of ACAAI, formerly JCAAI.

Save room for funTest your knowledge or just root for your favorite team at the FIT Bowl on Nov. 7. This fast-paced game show pits teams of FITs against each other as they battle for supremacy. After that, head to the President’s Welcome Reception to chat with old friends and make some new ones.

Get ready to rock at this year’s Annual Fundraising Event on Nov. 8, headlined by Blood, Sweat & Tears, featuring Bo Bice. Physician tickets are $250 each or $2,300 for a table, including cocktail reception, plated dinner with wine, and a show that will get you out of your seat and onto the dance floor. New this year, show only tickets are $55. All proceeds benefit the ACAAI Foundation. While there, bid against your colleagues (for a good cause) during the Alliance’s live auction.

San Antonio


Fall 2015 7


Tech tools make your meeting a breezeYou’re registered for the Annual Scientific Meeting and your hotel reservations are set — what else can you do to prepare? Get your gadgets ready to do everything from setting your schedule to connecting with colleagues with a simple swipe (or two).

Take your meeting mobileLeave your program book in your hotel room and download the meeting app. With the app, you can:

• Browse through sessions to find location, description, speakers and handouts.

• Build your own personalized schedule.

• Navigate the meeting with interactive floor plans.

• Search for specific speakers and exhibitors.

• Find colleagues attending the meeting and email them from the app.

• Get tips on where to dine in San Antonio.

Download it by searching for “ACAAI 2015” in your app store or visiting acaai.org/apps.

BYODInterested in the College Learning Connection (CLC) but not sure where to start? Bring your own device (phone or tablet – and we’ll have laptops, too) and stop by the College’s booth. Our staff will be ready to answer all your CLC questions and get you up and running in no time. Learn about the best CME opportunities, get help logging in, see where to access your CME certificates and more. Plus, while you’re at the booth, find out what the Advocacy Council, formerly JCAAI, has been doing for you, check out the progress of Vision 2020 and get answers to any of your College or Annual Scientific Meeting-related questions.

#BestMeetingEverFollow the College on Facebook, Twitter, Pinterest and YouTube – and get breaking Annual Scientific Meeting news as it happens. Hop on the hashtag #ACAAI to see what’s happening with other attendees. Get the conversation started by posting the best tips and pearls you heard in a lecture, or even share a selfie.

8 CollegeAdvantage

COMMUNITY ADVANTAGEBy Andrew Nickels, MD Senior FIT Representative to the ACAAI Board of Regents

Experts await FITs in San Antonio!Have you heard about the renowned speakers presenting during the Fellows-in-Training Educational Program on Nov. 6? Don’t miss:

• Immunology for the Boards and Wards, presented by Christina Ciaccio, MD, FACAAI, assistant professor of pediatrics at the University of Chicago. The great pursuit of understanding the immune system will be demystified during this presentation! Dr. Ciaccio is a champion of FIT education who led the Children’s Mercy/ACAAI Conferences Online Allergy for seven years and now continues her role as immunology professor on her website 312immunology.org.

• Using Social Media, Websites, and the Cloud to Improve Patient Care and Research, presented by Ves Dimov, MD. Knowing how to leverage these tools for the betterment of our patients and practices is essential! Dr. Dimov is an allergist/immunologist at the Cleveland Clinic Florida and clinical associate professor at FAU Charles E. Schmidt College of Medicine. He is an internationally recognized leader in physician and patient engagement technology. He is the founder of AllergyGoAway.com and PeriopMedicine.org, which have more than 10 million page views and

have been recognized by numerous scientific publications and medical schools.

• Excellence in Publications: Tips from the Editor of the Annals of Allergy, presented by the esteemed Gailen Marshall, MD, FACAAI. Getting published is a common goal of many FITs and having Dr. Marshall share his insights to the process will be enormously helpful! Dr. Marshall is the R. Faser Triplett, Sr., MD, Chair of Allergy and Immunology and professor of medicine and pediatrics at the University of Mississippi. You may better know him as the editor-in-chief of the Annals of Allergy, Asthma and Immunology.

Beyond the FIT Educational Program, there is plenty to do, including:• Nov. 6: FIT General Meeting, election of new FIT leadership and

Welcome Reception• Nov. 7: Doctors’ Job Fair and FIT Bowl Competition • Nov. 7: FIT/Allergy-Immunology Training Program Directors’

Breakfast, supported by Teva Respiratory.• Nov. 8: FIT/Allergy-Immunology Training Program Directors’

Luncheon, supported by Teva Respiratory

We look forward to seeing you in San Antonio!

Don’t forget: • Alliance Annual Business Meeting and

Luncheon, Nov. 8

• Live auction at the Fundraising Event, Nov. 8

COMMUNITY ADVANTAGEBy Judy Fineman, Alliance President

Plan on new friendships and experiencesThere’s more than enough to do and see in San Antonio — so make room in your schedule for events the Alliance has planned!Local flavor comes to youThe hospitality suite is open to registered spouses and guests from 8 – 10:30 a.m. Friday through Monday at the Grand Hyatt San Antonio hotel – so stop in! Fantastic speakers are lined up to bring the best of the southwest right to the meeting. A historian will give you the scoop on the area’s rich history on Nov. 6, a local artist will talk glassblowing, from functional to whimsical on Nov. 7 and Executive Chef David Wirebargh will whip up a special risotto on Nov. 8.

Globe-spanning connectionsThe10th annual International Reception takes place on Nov. 7, where international meeting attendees, their families and guests can meet the Alliance and College leadership. Refreshments, music and door prizes will add excitement to this southwestern-themed event.

Get off the beaten pathLooking to sightsee, but want some alternatives to the typical spots? Check out The Pearl neighborhood – home to some of the trendiest restaurants, bars, cafes and boutique shops in the area. Catch a movie at the Alamo Drafthouse, showing both classic and indie films and hosting fun quote- and sing-alongs. Rent a B-cycle from San Antonio’s bike sharing program – there are stations throughout downtown.

Fall 2015 9

Smart staffingThe results of a recent Medical Group Management Association (MGMA) survey indicate that higher-performing practices have more total support staff per full-time equivalent (FTE) physician. Unfortunately in many cases, physician offices are staffed so sparingly that, especially in clinic, the physician is often waiting on staff to complete a task before the room can be turned over.

At our office, an allergist gets approximately one FTE staff in clinic for every 10 patients they see in a day. An allergist who sees 30-35 patients a day has three clinical staff, and we try to schedule those three staff to the same allergist daily. This creates a more coherent team, and staff can often anticipate what the allergist will do. For example, in terms of patient education, staff has frequently already discussed treatments such as allergy testing and immunotherapy before the allergist enters the room, increasing efficiency.

Take advantage of techA second roadblock affecting efficiency of practices is the insufficient use of available technology, such as EHR systems. I have often observed practices attempting to utilize old processes within a new EHR system. However, it would benefit them to gain an understanding of the new system’s design and formulate new approaches that complement the capabilities of the new system.

Take the patient portal feature, for example. Most current systems have

robust patient portals which allow patients to complete paperwork, view lab results and request prescription refills. Some practices may be apprehensive about promoting this feature. At our office, we encourage both our new and returning patients to complete paperwork through the portal prior to their visit. Once at the office, the check-in process is expedited, allowing data to be uploaded quickly and the patient to be seen sooner.

The days of patients arriving 15 to 30 minutes early to fill out paperwork are over, and by minimizing the total time patients are in the office, we improve patient satisfaction. By encouraging patients to view lab

results and make refill requests via the portal, we reduce the number of phone calls to the office and have clearly documented data flow. When labs are ordered, we instruct the patient to check the portal in a week or two, after the allergist has been able to review the results and enter comments for the patient. In today’s changing health care environment, we constantly have to think of how we can increase efficiency. Make sure your staffing ratios are not limiting physician performance, and ensure you are using your EMR the way it was designed rather than trying to create a work around for an antiquated process.

PRACTICE MANAGEMENT ADVANTAGEBy Jason Biddy, MBA, Administrator, Alabama Allergy and Asthma Center, LLCACAAI Practice Management Committee Member

Can your practice perform better?What keeps you up at night? For many allergists, it’s wondering “How can I see more patients with limited resources and maintain efficiency?” In many cases, the answer is staffing appropriately and utilizing technology to its fullest potential.

10 CollegeAdvantage

IN MEMORIAM:

Gilbert Barkin, MD, FACAAIGilbert Barkin, MD, FACAAI, ACAAI president from 1982-83, passed away in his home on August 31, 2015, at the age of 86. Married to the love of his life Sandy (who passed away in 2007) for 52 years, he valued family, friends and community.

Dr. Barkin was a Fellow of the College for 56 years and received the Distinguished Fellow award in 1984. He was integral in some major changes that took place during 1982, including moving the offices from Boulder, Colorado to Chicago, initiating the first of many International Food Symposia, launching the College’s international program and recruiting younger allergists to join the College. The College grew in membership and saw increased financial stability in the following years.

“Gil was the key College physician behind the metamorphosis of the College from just a group that got together to share war stories to what it has become,” said Peter Boggs, MD, FACAAI. “It was Gil Barkin who assembled a

group of highly committed physicians of the College to take a close look at where we were, where we wanted to be, and to set about planning and implementation of how to get to the future. His name is “etched in gold” in the memories of those of us fortunate enough to have known him, worked with him and called him “friend.” The College is what it is today largely due to his very hard, dedicated efforts many years ago. When others look back on the evolution of this organization, there will be Gil, holding up a lantern, helping us find a better way.”

Dr. Barkin was a dedicated allergist who trained at George Washington Medical School, interned at Sinai Hospital, completed his residency at Washington University and an allergy fellowship at Baylor. He ran a solo practice in Silver Spring, Maryland for 40 years, treating three generations of patients.

Coming together for your professional developmentWhen the College’s Vision 2020 initiative launched, we committed to increasing our education offerings and engaging members in shaping the future of the College. This September, the Education Council, chaired by Dana Wallace, MD, FACAAI, made good on these promises, and initiated the ACAAI Education Summit.This inaugural Education Summit:

• Brought together College leaders in all areas of allergy/immunology education.

• Created a three-year roadmap for educational offerings.• Developed programs and resources members need for their professional

development and maintenance of certification.

“With dedicated preparation and the hard work of College CME professionals, we compacted three days of work into one intense, productive day! Starting with more than 50 ideas, we refined and detailed 12 fantastic, exciting CME initiatives for 2016-2018,” said Dr. Wallace. “While some ideas reinforce existing winning programs, other are so unique, so wild and so innovative you could never guess what they are! We are keeping these new ideas under lock and key until they are rolled out! This group not only had a ‘2020 Vision,’ they created the roadmap for ACAAI CME success!”

The College has already launched the College Learning Connection at education.acaai.org, which provides 24/7 access to first-class specialty content, courses and resources from experts in the field.

EDUCATION ADVANTAGE

Fall 2015 11

VOLUME 114 | NUMBER 3 | MARCH 2015

annallergy.org

Annalsof Allergy, Asthma & Immunology

OFFICIAL PUBLICATION OF THE AMERICAN COLLEGE OF ALLERGY, ASTHMA & IMMUNOLOGY

• Relationship between prenatal antibiotic use and

asthma in at-risk children

• National standards for asthma self-management

education

• Cannabis sativa: the unconventional “weed” allergen

• Oral immunotherapy in cow’s milk allergic patients:

course and long-term outcome according to

asthma status

• Early-life mold and tree sensitivity is associated with

allergic eosinophilic rhinitis at 4 years of age

“Debuting with the January 2016 issue, the new

Annals look is fresh and modern, yet scholarly, and sets us apart from

other, similar journals. I am particularly pleased with the way the cover emphasizes the most commonly used reference to our

journal — “Annals” — while providing a space for highlighting key articles and a relevant picture each month. I hope our members

and readers are as pleased with this new look as I am.”

— Gailen Marshall, MD, FACAAI, Annals editor-in-chief

“It is my distinct pleasure to report that

the visual presentation of AllergyWatch has been updated

to match the College’s new brand. We feel that combining the same

great content with a new design will enhance your experience reading this valuable College publication.”

— Stephen Tilles, MD, FACAAI, AllergyWatch

editor-in-chief

EDUCATION ADVANTAGE

Scientific publications get a makeover

1

New Generation of Anti-IL-5 Asthma

Biologics Nearing FDA ApprovalHigh blood eosinophil count increases the risk of asthma

exacerbations, suggesting that anti-interleukin 5 (IL-5) thera-

pies might be beneficial. Reslizumab, an investigational anti-

IL-5 monoclonal antibody, has shown short-term clinical effi-

cacy in asthma patients with sputum eosinophilia. This paper

reports two phase 3 clinical trials of reslizumab for patients

with inadequately controlled asthma and high blood

eosinophil counts.The two identical studies enrolled patients with moderate

to severe asthma that was uncontrolled despite medium- to

high-dose inhaled corticosteroids, with at least one exacer-

bation in the previous year, and a blood eosinophil count of

400 cells/mL or higher. Patients were randomly assigned to

treatment with intravenous reslizumab, 3.0 mg/kg, or place-

bo, given every 4 weeks for 1 year. The main outcome of

interest was annual rate of clinical asthma exacerbations.

Outcomes were analyzed in masked fashion.

A total of 477 patients were assigned to reslizumab and

476 to placebo. In both studies, the exacerbation rate was

significantly lower with reslizumab, compared to placebo:

rate ratio 0.50 in study 1 and 0.41 in study 2. Reslizumab

was also associated with improvement in FEV1 and in asthma

symptom, control, and quality of life scores.

The two groups had similar rates of adverse events, most

commonly worsening asthma symptoms, upper respiratory

tract infections, and nasopharyngitis. There were two cases

of anaphylaxis in the reslizumab group, both of which

responded to standard treatment. Eosinophil count

decreased during reslizumab treatment and rose again after

the end of treatment.

The American College of Allergy, Asthma & Immunology expresses

its appreciation to Merck for its grant in support of the publication of

AllergyWatch.®

2015 Editor-in-Chief Disclosure: Stephen A. Tilles, MD, Editor-in-Chief, Research Grants: AAAAI (mini-grant

recipient 2012), Amgen, Astellas, Astrazeneca,

Boehringer Ingelheim, Circassia, DBV Technologies, Genentech, Immune

Tolerance Network (NIH), Merck, Mylan, Novartis, Pulmagen, Stanford Univ.,

Sunovion, Teva. (Full editorial board disclosures can be found at www.acaai.org/

Pages/allergy-watch.aspx)

NOT FOR CREDITA Synopsis of Allergy and Asthma Literature, Resulting from an Unbiased,

Comprehensive Review of Twenty Major Medical Journals.

FEATURE ARTICLES..............................................

New Generation of Anti-IL-5 Asthma Biologics Nearing FDA Approval

Sputum Periostin Predicts Eosinophilic Phenotype in Severe Asthma.....

Gateway to a New Era? GATA3 Blockade in Allergic Asthma...............

Which Biomarkers Predict Corticosteroid Response in Asthma?............

Lipid Levels and Lipoprotein Particles Affect FEV1 in Asthma................

In Obese Kids, Asthma Symptoms Are Different....................................

Weight Loss Helps Obese Adults with 'Real' Asthma............................

Peanut SLIT and OIT-Latest Clinical Trials.............................................

Outgrowing Peanut Allergy: Follow-up and Predictive Cutoffs...............

Four-Injection Cat Peptide Immunotherapy: Still Working at 2 Years?...Steroid Bursts: Are Adverse Effects Overblown?...................................

Atopy Affects Exhaled NO Levels in African American Children.............

Shared Patient Portal Can Improve Asthma Outcomes..........................

Cognitive Function and Health Literacy Affect Adherence in Older

Asthma Patients................................................................................Chemically Modified Peanut Extracts Show Reduced Allergenicity.........

Do VIT Patients Really Need to Stop Beta-Blockers and ACE

Inhibitors?...........................................................................................

Does Asthma Knowledge Correlate with Asthma Control in the

Elderly?.............................................................................................

Link between Childhood Asthma and ADHD?....................................Can Diagnostic Codes Help Us Identify Chronic Urticaria?.................REVIEWS OF NOTE ..............................................................

Longitudinal Outcomes of Adult Asthma: 7-Year Follow-Up...............

New Test for Basophil Suppression after Immunotherapy.....................

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A PUBLICATION OF THE AMERICAN COLLEGE OF ALLERGY, ASTHMA & IMMUNOLOGYVolume 17, Number 4 • July-August 2015

New Layout Allergy Watch 2015:new layout 7/24/15 12:56 PM Page 1

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12 CollegeAdvantage

PATIENT ADVANTAGE

Penicillin allergy – get the tools to give your patients the facts!

PATIENT ADVANTAGE

Protecting kids, saving livesAlmost every state has passed stock epinephrine laws requiring anaphylaxis emergency preparedness plans that allow schools to obtain and stock emergency epinephrine auto-injectors. But many schools face a challenge – they struggle to obtain standing orders and prescriptions for these undesignated auto-injectors. This is where College members can help.

Working with the Allergy and Asthma Network, and supported by Mylan, the College put together a toolkit with everything you need to provide a standing order and prescription for epinephrine auto-injectors to schools in your area. You can also find links to your state’s full law and information about liability. You can download the toolkit for free in the Member Store on acaai.org.

INCLUDES:

EMERGENCY EPINEPHRINE ACT

Allergists’ Toolkit

Supported by

Protecting students

from life-threatening allergic reactions

Supported by

• Letter to the Physician

• Standing Order

• Prescription for Epinephrine

Auto-Injectors

• Liability Information

• State Laws

• Resources

Do you have patients who have been told they are penicillin-allergic but have never been tested? Do they have the diagnosis “penicillin-allergic” permanently in their medical chart, but don’t actually know if they’re allergic? If you do, you are certainly not alone. Many allergists are frustrated by the large numbers of patients who don’t know what their penicillin-allergic status really is. If these patients were tested, more than 90 percent would find they are not allergic, and could begin using penicillin, when appropriate.

The College’s former Drug Allergy and Anaphylaxis Committee, now the Anaphylaxis Committee, created a member toolkit containing everything needed to test patients and reach out to those in need of testing.

“We want members to have everything they need to talk to insurance companies, patients and primary care physicians. They can get the message out that it’s necessary to find out definitively if their patients who believe they are penicillin-allergic really are,” said Dana Wallace, MD, FACAAI, committee member and project leader.

The toolkit contains:

• Guidelines for insurance companies on testing challenge — Information on testing, answers to questions about indications for testing and oral challenge, contraindications to testing, when to perform skin tests, what to do with skin test results and references.

• Skin testing worksheet — These instructions walk you through skin testing, dosing, equipment and supplies needed, nursing instructions and treatment of an acute reaction.

• Consent forms — Covering desensitization, skin testing, and oral test dosing and challenge.

• Cost and supplies information sheet.

• CPT codes and expected reimbursement.

• Marketing materials — Press releases, scripts, articles and more help you get the word out — to the media and the public — on the importance of testing for penicillin allergy.

• Lecture — This presentation helps you inform other clinicians.

• Patient information sheets — Fact sheets and FAQs for your patients to help them to more completely understand testing.

Download the entire toolkit in the Member Store on acaai.org. And, to learn more about the toolkit and how to use it, attend the Penicillin (Beta-Lactam) Toolkit workshop on Nov. 9 at the Annual Scientific Meeting.

And the winner is…

Fall 2015 13

The Gold Headed Cane Award is annually given to a College Fellow who has demonstrated the highest standards of scientific excellence and integrity. This year, College Fellows selected Eli Meltzer, MD, FACAAI, who will be presented with the award at the Annual Scientific Meeting on Nov. 7.

“I feel very fortunate to have chosen the medical profession, participated in the extraordinary progress in allergy/immunology and been able to help improve the health and well-being of patients’ lives,” said Dr. Meltzer.

A Fellow of the College for 38 years, Dr. Meltzer has served on the Ear, Nose and Throat and Rhinitis/Rhinosinusitis Committees. Since 1987, Dr. Meltzer has given more than 80 presentations at ACAAI Annual Scientific Meetings.

He has been honored by the College as Master in Allergy, a Distinguished Fellow, and a Jaros Memorial Lecturer. And Dr. Meltzer and his wife, Susie, were even crowned the ACAAI Jitterbug Contest Champions during the 50th Annual Scientific Meeting.

Dr. Meltzer has participated in national and international advisory groups including the U.S. Food and Drug Administration’s Pulmonary/Allergy Advisory Committee, the U.S. Rhinosinusitis Initiative, the Editorial Board of the American Journal of Rhinology and Allergy, the Joint Task Force Rhinitis Practice Parameter Committee and the World Health Organization’s Allergic Rhinitis Impact on Asthma and InterAirways initiatives. He also served as president of the

San Diego Allergy Society, the California Society of Allergy and Clinical Immunology, and the Joint Council of Allergy, Asthma and Immunology.

Dr. Meltzer is clinical professor of pediatrics at the University of California, San Diego (USCD), and past chief, division of allergy and immunology at Rady Children’s Hospital in San Diego. After 15 years as chair of the Well-Being Committee, he was honored for “Outstanding dedication, counseling, and commitment to ensure the physical and mental well-being of all physicians on the medical staff.” He is a founder of the Allergy/Immunology Fellowship Training Program at UCSD and, for decades, faculty for allergy/immunology fellows at the Scripps Clinic and Research Foundation.

For more than 40 years, Dr. Meltzer has been a clinician with the Allergy & Asthma Medical Group & Research Center in San Diego. He was recognized by the Sharp Community Medical Group because of his knowledge and compassion for “Excellence in patient satisfaction.” He has participated in more than 650 research studies focused on various diagnostic aspects of and treatments for respiratory diseases. He has also been an invited lecturer to a broad array of specialists in more than two thirds of U.S. states and in more than 30 countries on topics including asthma, rhinitis, sinusitis, anaphylaxis, pharmacotherapy and immunotherapy, and he has authored more than 600 scientific publications.

COMMUNITY ADVANTAGE


Call for Proposals is now open for the 2016 Annual Scientific MeetingThe landscape of medicine is changing. What impact will that have on our profession and our patients? What guidance and pragmatic tools are needed to not only survive, but thrive in the practice of allergy and immunology?The 2016 meeting theme is “Practice Advantage – New Times. New Treatments. New Standards.” The College is accepting session/presentation proposals that echo the meeting theme, stimulate discussion and challenge mindsets. Find out more at annualmeeting2016.acaai.org. Deadline for submission is December 31, 2015.

14 CollegeAdvantage

COMMUNITY ADVANTAGE

Honoring our award winnersJames Sublett, MD, FACAAI, ACAAI president, takes a moment to reflect on the contributions of this year’s winners.

Distinguished Fellow Award

Warner Carr, MD, FACAAI“ Dr. Carr is a tireless advocate and worker for the College since his days as a FIT Representative on the Board. He is a great role model for any young member who would like to get involved with ACAAI.”

Kevin McGrath, MD, FACAAI“ When I think of Dr. McGrath, I think of someone who is not afraid to ask the “hard questions” that the leadership of the College need to address to make the College a better organization.”

J. Allen Meadows, MD, FACAAI“ Having worked with Dr. Meadows for many years on the JCAAI, I know of no member more dedicated to advocating for our specialty at both the local and national level. His experience and leadership of the Advocacy Council of ACAAI brings a special dimension to its activities.”

International Distinguished Fellow Award

Nelson Rosario-Filho, MD, FACAAI from Curitiba, Brazil“ We are honored to present this well-deserved award for Dr. Rosario-Filho’s work, both with the College, and the international allergy community, including the WAO.”

Distinguished Service AwardIn memoriam: Ms. Mary Lou Callaghan“ Mary Lou was a very, very special individual who we all sorely miss. When I think of Mary Lou, the words “execution” and “accountability” come to mind. She was tireless in her ability to execute and deliver on any project that was handed to her. She was never afraid to hold accountable the many distinguished speakers that make up our annual programs, but only to the degree that she was accountable herself. Her ability to juggle and manage the many components of the Annual Scientific Meeting still amazes me.”

Women in Allergy AwardChitra Dinakar, MD, FACAAI“ Dr. Dinakar is one of those “go-to individuals” who is always willing, when asked, to step up and take a leadership role. Whether it’s leading the development of a Practice Parameter, or chairing a College committee, we know the job will be done well and on time.”

Dr. Warner Carr Dr. Kevin McGrath Dr. J. Allen Meadows Dr. Nelson Rosario-Filho Ms. Mary Lou Callaghan Dr. Chitra Dinakar

All attendees are invited to the Awards Ceremony held during the Annual Scientific Meeting on Saturday, Nov. 7. The College will welcome new Fellows and recognize recipients of its Distinguished Fellow Awards, Distinguished Service Award and Women in Allergy Award.

Fall 2015 15

COMMUNITY ADVANTAGE

Meet the 2015-16 candidates for electionDuring the 2015 Annual Business Meeting, College Fellows will elect a president-elect, vice president, and treasurer for one-year terms. They also will elect three regents for three year terms. The nominees proposed by the Nominating Committee embody the philosophy of their predecessors whose combined efforts have made the College the success it is today.

“I am honored to continue to serve ACAAI and, in the midst of substantial recent challenges, I look forward to helping the College fulfill its mission to promote practice excellence.”

— Stephen Tilles, MD, FACAAI, president-elect

“The College is moving to better serve our membership with their medical education and practice management needs. I believe these goals will be reached with an expanded involvement of our membership.”

— Bradley Chipps, MD, FACAAI, vice president

“In line with Vision 2020, I envision the College to be in the forefront of education, patient care, advocacy and research. I envision more involvement of international members, women and other minorities, fellows-in-training and medical students

in our organization. I think the time is now and ACAAI is the organization to lead the way.”

— Luz Fonacier, MD, FACAAI, treasurer

“Let’s go global! The College has continued a longstanding tradition of promoting excellence in patient care, education, advocacy and research within the United States. Building on the College’s strength and expertise, we need to expand our reach,

service and impact of the sub-specialty beyond our borders and at a global level.”

— Jayesh Kanuga, MD, FACAAI, regent

“I am looking forward to working with and learning from the current College leadership. I hope to bring a fresh, in-the-trenches perspective of the concerns and problems facing the practicing allergist. I look forward to the College

increasingly being the voice of the practicing allergist in the areas of reimbursement, CMS reporting requirements and MOC issues.”

— Michael Manning, MD, FACAAI, regent

“The profession of allergy and immunology faces many challenges, including increasing competition, declining reimbursements, long-term manpower challenges and integration with health care reform. As Fellows, it is our

responsibility to ensure its visibility, viability and vitality for future generations and the patients we serve. With courage and imagination, we can meet these challenges. I am humbled to serve our profession, patients and the College.”

— James Tracy, DO, FACAAI, regent

View full bios at college.acaai.org/201516Candidates

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